TY - JOUR
T1 - Clinicians' conflicting emotional responses to high suicide-risk patients—Association with short-term suicide behaviors
T2 - A prospective pilot study
AU - Yaseen, Zimri S.
AU - Galynker, Igor I.
AU - Cohen, Lisa J.
AU - Briggs, Jessica
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background Clinician's emotional responses to patients have been recognized as potentially relating to treatment outcome, however they have received little attention in the literature on suicide risk. We examine the relationship between a novel targeted measure of clinicians' emotional responses to high-risk psychiatric inpatients and their short-term post-discharge suicide behavior. Methods First-year psychiatry residents' emotional responses to their patients were assessed anonymously with the novel self-report ‘Therapist Response Questionnaire-Suicide Form’ (TRQ-SF). Patient outcomes were assessed at 1–2 months post-discharge, and post-discharge suicide outcomes were assessed with the Columbia Suicide Severity Rating Scale. Following exploratory factor analysis of the TRQ-SF, scores on the resultant factors were examined for relationships with clinical and demographic measures and post-discharge suicide behavior. Results A two-factor model fit the data, with factors reflecting dimensions of affiliation/rejection and distress/non-distress. Two items that did not load robustly on either factor had face validity for hopefulness and hopelessness and were combined as a measure along a hopefulness/hopelessness dimension. The interaction Distress × Hopefulness, reflecting a conflicting emotional response pattern, significantly predicted post-discharge suicide outcomes even after covarying for depression, entrapment, and suicidal ideation severity. Conclusion Clinicians' conflicting emotional responses to high-risk patients predicted subsequent suicidal behavior, independent of traditional risk factors. Our findings demonstrate the potential clinical value of assessing such responses.
AB - Background Clinician's emotional responses to patients have been recognized as potentially relating to treatment outcome, however they have received little attention in the literature on suicide risk. We examine the relationship between a novel targeted measure of clinicians' emotional responses to high-risk psychiatric inpatients and their short-term post-discharge suicide behavior. Methods First-year psychiatry residents' emotional responses to their patients were assessed anonymously with the novel self-report ‘Therapist Response Questionnaire-Suicide Form’ (TRQ-SF). Patient outcomes were assessed at 1–2 months post-discharge, and post-discharge suicide outcomes were assessed with the Columbia Suicide Severity Rating Scale. Following exploratory factor analysis of the TRQ-SF, scores on the resultant factors were examined for relationships with clinical and demographic measures and post-discharge suicide behavior. Results A two-factor model fit the data, with factors reflecting dimensions of affiliation/rejection and distress/non-distress. Two items that did not load robustly on either factor had face validity for hopefulness and hopelessness and were combined as a measure along a hopefulness/hopelessness dimension. The interaction Distress × Hopefulness, reflecting a conflicting emotional response pattern, significantly predicted post-discharge suicide outcomes even after covarying for depression, entrapment, and suicidal ideation severity. Conclusion Clinicians' conflicting emotional responses to high-risk patients predicted subsequent suicidal behavior, independent of traditional risk factors. Our findings demonstrate the potential clinical value of assessing such responses.
UR - http://www.scopus.com/inward/record.url?scp=85017616052&partnerID=8YFLogxK
U2 - 10.1016/j.comppsych.2017.03.013
DO - 10.1016/j.comppsych.2017.03.013
M3 - Article
C2 - 28431270
AN - SCOPUS:85017616052
SN - 0010-440X
VL - 76
SP - 69
EP - 78
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
ER -